Hussain Bux Maitlo, Khalid Amjad Kiyani, Rafi Ahmad Ghouri, Mashood A Khan.
Ultrasound guided needle aspiration of liver abscess (Amoebic & Pyogenic).
Med Channel Jan ;11(1):46-8.

OBJECTIVE: To evaluate effectiveness of needle aspiration in treatment and prevention of complication of liver abscess. DESIGN: It was a prospective and comparative case series study. PLACE AND DURATION OF STUDY: Civil Hospital Mirpur Khas and Mehran Ultra sound centre co-authors private clinic over a period of ten years from 1st Jan 1995 to 31st Dec 2004. PATIENTS AND METHODS: This study included 136 cases, amoebic liver abscess 76 cases, 54 cases of Pyogenic liver abscess and 6 cases of Hydatid cyst. The cases of hydatid cyst and abscess less than 5cm in size were excluded on ultra sonography. Thirty cases of liver abscess less than five centimeter in size were treated conservatively and excluded from the study. Abscess more than 5cm in size received conservative treatment, combination of metronidazole, cephalosporin and chloroquine and not responding were subjected to needle aspiration under ultrasound guidance. Cases were diagnosed on the basis of history, clinical examination, lab investigations, x-ray and ultra sonography. Patients were aspirated with local anesthesia under strict aseptic measures. Six patients suffered vasovagal shock during procedure and recovered completely, after receiving first aid treatment. Three patients suffered rupture of abscess in abdominal cavity and were referred to surgical specialist for management. The aspirated fluid was sent to laboratory for microbial examination. RESULTS: I. Abscesses of less than 5cm were treated conservatively. II. Abscesses of 6-10cm size were treated conservatively and one or two needle aspirations. III. Abscesses above 10-15 cm treated on conservative treatment and three to four needle aspirations. IV. Abscesses of 15-7cm were referred to surgical specialist for management. V Cases of hydatidicyst and abscesses of less than 5cm were excluded from the study. CONCLUSION: Treatment of Liver abscess with ultrasound guided needle aspiration is effective and economical with little complications of procedure.

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